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 NURS 6501 Week 9:Discuss Concepts of Psychological Disorders

 NURS 6501 Week 9:Discuss Concepts of Psychological Disorders

  1. What are the known characteristics of schizophrenia and relate those to this patient?

Schizophrenia is a chronic mental disorder displayed in patients who interpreted reality abnormally just like the 22-year-old patient in the provided case study. It can lead to a combination of delusion. Hallucination and extremely disordered behaviour and thinking impair the patient normal functioning (Correll et al., 2019). The patient in the provided case study reported signs of auditory and visual hallucination, unexpected rage and crying, and delusion. Additional symptoms include disorganized speech and thinking as demonstrated by the results of the mental status examination. The patient also displayed negative symptoms such as inability to make eye contact and being socially withdrawn which are significant indications of schizophrenia disorder.

  1. Genetics are sometimes attached to schizophrenia explains this.

Pre-molecular and molecular genetic studies have reported that genetics play a significant role in the development of schizophrenia.  Consequently, the inheritance pattern of the disease demonstrates increased risk among first relatives. At the molecular level, several positional and functional genes associated with the development of schizophrenia have been identified, such as neuregulin (NRG-1, 8p12–21), proline dehydrogenase (PRODH-2, 22q11.21), dysbindin, (DTNBP1,6p22.3), catechol-O-methyltransferase (COMT, 22q11.21), G72 (13q34) / D-amino acid oxidase (DAAO,12q24),5HT2A and dopamine D3 receptor (DRD3) and regulator of G protein signaling (RGS-4) (Cleynen et al., 2021). Recent studies support schizophrenia candidate regions on chromosomes 1q, 2q, 5q, 6p, 8p, 10p, 13q,15q and 22q. Additional studies are however required to provide a precise association with the above-mentioned genetic factors concerning how they lead to the development of schizophrenia.

  1. What roles do neurotransmitters play in the development of schizophrenia?

Neurotransmitters are chemicals responsible for conveying messages between brain cells. Studies illustrate an association between changes in the levels of neurotransmitters in the brain to the development of schizophrenia. This is evident by the mechanism of antipsychotics in relieving symptoms of schizophrenia through altering the levels of certain neurotransmitters in the brain. Recent studies have reported several biochemical alterations in schizophrenia, concerningneurotransmitter dysfunction in different systems, with the most prominent being γ‎-aminobutyric acid (GABA), serotonin, glutamate, and dopamine (Müller, 2018). For instance, alterations in the signaling of dopamine and hyperactivity of the D2 receptor in the limbic and subcortical region of the brain have been associated with some of the schizophrenia symptoms including delusion and hallucination. Consequently, hypodopaminergic activity in the mesocortical system is also associated with negative symptoms of schizophrenia such as flattening, lack of pleasure, withdrawal, and inability to follow through.

 NURS 6501 Week 9:Discuss Concepts of Psychological Disorders

  1. Explain what structural abnormalities are seen in people with schizophrenia.

Through imaging studies, several complex patterns of structural abnormalities have been reported among patients diagnosed with schizophrenia, in addition to those who are at high risk of the disorder (Zhao et al., 2018). For example, MRI studies have reported a reduced volume of grey matter in the prefrontal, superior temporal, and medial temporal areas of the brain. These regions of the brain are involved in several functions such as short-term memory/decision making, processing of auditory information, and episodic memory respectively. Postmortem studies on the other hand report that a reduction in the cortical grey matter does not indicate loss of cell bodies but instead, reflects a reduction in synaptic density and dendritic complexity which may impair intraneuronal integration and communication leading to cognitive changes among other associated symptoms. Disruptions in the integrity of the white matter have also been implicated in schizophrenia, given that it forms the structural connections between different regions of the brain.

Scenario 2: Bipolar Disorder

  1. How does genetics play in the development of bipolar 2 disorders?  

Bipolar disorder (BD) is characterized by extreme shifts in the patient’s mood, behaviour, and energy levels. The patient in the provided case study is however diagnosed with bipolar 2 disorder, which is characterized by hypomanic and depressive episodes. The inheritance pattern of bipolar 2 disorder is quite unclear. Studies however report greater risks among first-degree relatives, with genetic factors accounting for approximately 80% of the causes of this mental disorder (Gordovez& McMahon, 2020). Genome-wide association studies (GWASs) have associated increased risk of bipolar 2 disorder with several genetic factors such as alpha-1 subunit of the L-type voltage-gated calcium channel (CACNA1C), teneurin transmembrane protein 4 (ODZ4), ankyrin G node of Ranvier (ANK3), nesprin-1 (SYNE1) and diacylglycerol kinase eta (DGKH).For instance, the DGKH is involved in diacylglycerol (DAG) phosphorylation in the phosphoinositol pathway sensitive to lithium, which contributes to the development of the bipolar disorder.

References

Cleynen, I., Engchuan, W., Hestand, M. S., Heung, T., Holleman, A. M., Johnston, H. R., … & Bassett, A. S. (2021). Genetic contributors to the risk of schizophrenia in the presence of a 22q11. 2 deletion. Molecular psychiatry26(8), 4496-4510. https://doi.org/10.1038/s41380-020-0654-3

Correll, C. U., Brevig, T., & Brain, C. (2019). Patient characteristics, burden, and pharmacotherapy of treatment-resistant schizophrenia: results from a survey of 204 US psychiatrists. BMC psychiatry19(1), 1-12. https://doi.org/10.1186/s12888-019-2318-x

Gordovez, F. J. A., & McMahon, F. J. (2020). The genetics of bipolar disorder. Molecular psychiatry25(3), 544-559.https://doi.org/10.1038/s41380-019-0634-7

Müller, N. (2018). Inflammation in schizophrenia: pathogenetic aspects and therapeutic considerations. Schizophrenia bulletin44(5), 973-982. https://doi.org/10.1093/schbul/sby024

Zhao, C., Zhu, J., Liu, X., Pu, C., Lai, Y., Chen, L., … & Hong, N. (2018). Structural and functional brain abnormalities in schizophrenia: a cross-sectional study at different stages of the disease. Progress in Neuro-Psychopharmacology and Biological Psychiatry83, 27-32. https://doi.org/10.1016/j.pnpbp.2017.12.017.

Among the many risk factors for mental disorders are genetics and other pathophysiological factors. While other factors, such as environmental factors or substance abuse, can also have an impact, it is important to recognize the connections between biological factors and psychological disorders.

Ranging from anxiety to schizophrenia, psychological disorders offer unique challenges in diagnosis and treatment. Clearly, the presence of these disorders can be life-altering for patients, but they can also significantly impact families and other loved ones.

This week, you examine fundamental concepts of psychological disorders. You explore common psychological disorders, and you apply the key terms and concepts that help communicate the pathophysiological nature of these issues to patients.

Learning Objectives

Students will:

  •  Analyze concepts and principles of pathophysiology across the lifespan

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Learning Resources

Required Readings (click to expand/reduce)

 

McCance, K. L. & Huether, S. E. (2019). Pathophysiology: The biologic basis for disease in adults and children (8th ed.). St. Louis, MO: Mosby/Elsevier.

  • Chapter 19: Neurobiology of Schizophrenia, Mood Disorders, Anxiety Disorders, and Obsessive-Compulsive Disorder, including Summary Review

Locke, A. B., Kirst, N., & Shultz, C. G. (2015). Diagnosis and management of generalized anxiety disorder and panic disorder in adults. American Family Physician, 91(9), 617–624. Retrieved from https://www.aafp.org/afp/2015/0501/p617.html

Credit Line: Diagnosis and management of generalized anxiety disorder and panic disorder in adults by Locke, A. B., Kirst, N., & Shultz, C., in American Family Physician, Vol. 91/Issue 9. Copyright 2015 by American Academy of Family Physicians. Reprinted by permission of American Academy of Family Physicians via the Copyright Clearance Center.

McIntyre, R. S. & Calabrese, J. R. (2019). Bipolar depression: The clinical characteristics and unmet needs of a complex disorder. Current Medical Research and Opinion, 1–14. doi:10.1080/03007995.2019.1636017. Retrieved from https://www.tandfonline.com/doi/full/10.1080/03007995.2019.1636017

Credit Line: Bipolar depression: The clinical characteristics and unmet needs of a complex disorder by McIntyre, R. S. & Calabrese, J. R., in Current Medical Research and Opinion. Copyright 2019 by Librapharm Ltd. Reprinted by permission of Librapharm Ltd via the Copyright Clearance Center.

 

Required Media (click to expand/reduce)

 

Module 6 Overview with Dr. Tara Harris 

Dr. Tara Harris reviews the structure of Module 6 as well as the expectations for the module. Consider how you will manage your time as you review your media and Learning Resources throughout the module to prepare for your Knowledge Check. (1m)

Generalized Anxiety Syndrome

Osmosis.org. (2016, February 29). Generalized anxiety disorder (GAD) – causes, symptoms, & treatment [Video file]. Retrieved from https://www.youtube.com/watch?v=9mPwQTiMSj8

Note: The approximate length of the media program is 5 minutes.

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